|
PR I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE
|
Professional
|
Both
|
$397.00
|
|
|
Service Code
|
HCPCS 54700
|
| Min. Negotiated Rate |
$136.53 |
| Max. Negotiated Rate |
$2,037.12 |
| Rate for Payer: Aetna Commercial |
$277.93
|
| Rate for Payer: Aetna Medicare |
$207.41
|
| Rate for Payer: BCBS Complete |
$143.36
|
| Rate for Payer: BCBS MAPPO |
$207.41
|
| Rate for Payer: BCBS Trust/PPO |
$2,037.12
|
| Rate for Payer: BCN Commercial |
$307.87
|
| Rate for Payer: BCN Medicare Advantage |
$207.41
|
| Rate for Payer: Cash Price |
$317.60
|
| Rate for Payer: Cash Price |
$317.60
|
| Rate for Payer: Cofinity Commercial |
$277.93
|
| Rate for Payer: Cofinity Commercial |
$298.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$207.41
|
| Rate for Payer: Healthscope Commercial |
$248.89
|
| Rate for Payer: Healthscope Whirlpool |
$248.89
|
| Rate for Payer: Meridian Medicaid |
$143.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$217.78
|
| Rate for Payer: PACE SWMI |
$207.41
|
| Rate for Payer: PHP Medicare Advantage |
$207.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$136.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$277.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$340.43
|
| Rate for Payer: Priority Health Medicare |
$207.41
|
| Rate for Payer: Priority Health Narrow Network |
$340.43
|
| Rate for Payer: UHC Medicare Advantage |
$213.63
|
|
|
PR I&D FOREARM&/WRIST DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$913.00
|
|
|
Service Code
|
HCPCS 25028
|
| Min. Negotiated Rate |
$209.74 |
| Max. Negotiated Rate |
$1,072.36 |
| Rate for Payer: Aetna Commercial |
$898.44
|
| Rate for Payer: Aetna Medicare |
$670.48
|
| Rate for Payer: BCBS Complete |
$469.66
|
| Rate for Payer: BCBS MAPPO |
$670.48
|
| Rate for Payer: BCBS Trust/PPO |
$209.74
|
| Rate for Payer: BCN Commercial |
$1,026.22
|
| Rate for Payer: BCN Medicare Advantage |
$670.48
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Cofinity Commercial |
$965.49
|
| Rate for Payer: Cofinity Commercial |
$898.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$670.48
|
| Rate for Payer: Healthscope Commercial |
$804.58
|
| Rate for Payer: Healthscope Whirlpool |
$804.58
|
| Rate for Payer: Meridian Medicaid |
$469.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$704.00
|
| Rate for Payer: PACE SWMI |
$670.48
|
| Rate for Payer: PHP Medicare Advantage |
$670.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$639.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,072.36
|
| Rate for Payer: Priority Health Medicare |
$670.48
|
| Rate for Payer: Priority Health Narrow Network |
$1,072.36
|
| Rate for Payer: UHC Medicare Advantage |
$690.59
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Facility
|
IP
|
$264.00
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
10140
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$184.80 |
| Max. Negotiated Rate |
$264.00 |
| Rate for Payer: Aetna Commercial |
$237.60
|
| Rate for Payer: ASR ASR |
$256.08
|
| Rate for Payer: BCBS Trust/PPO |
$204.68
|
| Rate for Payer: BCN Commercial |
$204.68
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cofinity Commercial |
$248.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.20
|
| Rate for Payer: Healthscope Commercial |
$264.00
|
| Rate for Payer: Healthscope Whirlpool |
$256.08
|
| Rate for Payer: Mclaren Commercial |
$237.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$224.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$232.32
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Professional
|
Both
|
$264.00
|
|
|
Service Code
|
HCPCS 10140
|
| Hospital Charge Code |
10140
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$199.08 |
| Rate for Payer: Aetna Commercial |
$153.08
|
| Rate for Payer: Aetna Medicare |
$114.24
|
| Rate for Payer: BCBS Complete |
$79.84
|
| Rate for Payer: BCBS MAPPO |
$114.24
|
| Rate for Payer: BCBS Trust/PPO |
$12.91
|
| Rate for Payer: BCN Commercial |
$199.08
|
| Rate for Payer: BCN Medicare Advantage |
$114.24
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cofinity Commercial |
$164.51
|
| Rate for Payer: Cofinity Commercial |
$153.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.24
|
| Rate for Payer: Healthscope Commercial |
$137.09
|
| Rate for Payer: Healthscope Whirlpool |
$137.09
|
| Rate for Payer: Meridian Medicaid |
$79.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.95
|
| Rate for Payer: PACE SWMI |
$114.24
|
| Rate for Payer: PHP Medicare Advantage |
$114.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.27
|
| Rate for Payer: Priority Health Medicare |
$114.24
|
| Rate for Payer: Priority Health Narrow Network |
$144.27
|
| Rate for Payer: UHC Medicare Advantage |
$117.67
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Professional
|
Both
|
$264.00
|
|
|
Service Code
|
HCPCS 10140
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$199.08 |
| Rate for Payer: Aetna Commercial |
$153.08
|
| Rate for Payer: Aetna Medicare |
$114.24
|
| Rate for Payer: BCBS Complete |
$79.84
|
| Rate for Payer: BCBS MAPPO |
$114.24
|
| Rate for Payer: BCBS Trust/PPO |
$12.91
|
| Rate for Payer: BCN Commercial |
$199.08
|
| Rate for Payer: BCN Medicare Advantage |
$114.24
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cofinity Commercial |
$153.08
|
| Rate for Payer: Cofinity Commercial |
$164.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.24
|
| Rate for Payer: Healthscope Commercial |
$137.09
|
| Rate for Payer: Healthscope Whirlpool |
$137.09
|
| Rate for Payer: Meridian Medicaid |
$79.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.95
|
| Rate for Payer: PACE SWMI |
$114.24
|
| Rate for Payer: PHP Medicare Advantage |
$114.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.27
|
| Rate for Payer: Priority Health Medicare |
$114.24
|
| Rate for Payer: Priority Health Narrow Network |
$144.27
|
| Rate for Payer: UHC Medicare Advantage |
$117.67
|
|
|
PR I&D HEMATOMA SEROMA/FLUID COLLECTION
|
Facility
|
OP
|
$264.00
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
10140
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$184.80 |
| Max. Negotiated Rate |
$1,839.94 |
| Rate for Payer: Aetna Commercial |
$237.60
|
| Rate for Payer: Aetna Medicare |
$1,441.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: ASR ASR |
$256.08
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$204.68
|
| Rate for Payer: BCN Commercial |
$204.68
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cash Price |
$211.20
|
| Rate for Payer: Cofinity Commercial |
$248.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$264.00
|
| Rate for Payer: Healthscope Whirlpool |
$256.08
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Commercial |
$237.60
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$224.40
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,585.24
|
| Rate for Payer: PHP Medicaid |
$788.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,839.94
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$1,471.95
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$232.32
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: VA VA |
$1,441.13
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Facility
|
IP
|
$722.00
|
|
|
Service Code
|
CPT 46045
|
| Hospital Charge Code |
46045
|
| Min. Negotiated Rate |
$505.40 |
| Max. Negotiated Rate |
$722.00 |
| Rate for Payer: Aetna Commercial |
$649.80
|
| Rate for Payer: ASR ASR |
$700.34
|
| Rate for Payer: BCBS Trust/PPO |
$559.77
|
| Rate for Payer: BCN Commercial |
$559.77
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Cofinity Commercial |
$678.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$577.60
|
| Rate for Payer: Healthscope Commercial |
$722.00
|
| Rate for Payer: Healthscope Whirlpool |
$700.34
|
| Rate for Payer: Mclaren Commercial |
$649.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$613.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$635.36
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Professional
|
Both
|
$722.00
|
|
|
Service Code
|
HCPCS 46045
|
| Hospital Charge Code |
46045
|
| Min. Negotiated Rate |
$283.50 |
| Max. Negotiated Rate |
$2,294.94 |
| Rate for Payer: Aetna Commercial |
$577.41
|
| Rate for Payer: Aetna Medicare |
$430.90
|
| Rate for Payer: BCBS Complete |
$297.68
|
| Rate for Payer: BCBS MAPPO |
$430.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,294.94
|
| Rate for Payer: BCN Commercial |
$644.08
|
| Rate for Payer: BCN Medicare Advantage |
$430.90
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Cofinity Commercial |
$577.41
|
| Rate for Payer: Cofinity Commercial |
$620.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$430.90
|
| Rate for Payer: Healthscope Commercial |
$517.08
|
| Rate for Payer: Healthscope Whirlpool |
$517.08
|
| Rate for Payer: Meridian Medicaid |
$297.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$452.44
|
| Rate for Payer: PACE SWMI |
$430.90
|
| Rate for Payer: PHP Medicare Advantage |
$430.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$283.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$774.94
|
| Rate for Payer: Priority Health Medicare |
$430.90
|
| Rate for Payer: Priority Health Narrow Network |
$774.94
|
| Rate for Payer: UHC Medicare Advantage |
$443.83
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Professional
|
Both
|
$722.00
|
|
|
Service Code
|
HCPCS 46045
|
| Min. Negotiated Rate |
$283.50 |
| Max. Negotiated Rate |
$2,294.94 |
| Rate for Payer: Aetna Commercial |
$577.41
|
| Rate for Payer: Aetna Medicare |
$430.90
|
| Rate for Payer: BCBS Complete |
$297.68
|
| Rate for Payer: BCBS MAPPO |
$430.90
|
| Rate for Payer: BCBS Trust/PPO |
$2,294.94
|
| Rate for Payer: BCN Commercial |
$644.08
|
| Rate for Payer: BCN Medicare Advantage |
$430.90
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Cofinity Commercial |
$620.50
|
| Rate for Payer: Cofinity Commercial |
$577.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$430.90
|
| Rate for Payer: Healthscope Commercial |
$517.08
|
| Rate for Payer: Healthscope Whirlpool |
$517.08
|
| Rate for Payer: Meridian Medicaid |
$297.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$452.44
|
| Rate for Payer: PACE SWMI |
$430.90
|
| Rate for Payer: PHP Medicare Advantage |
$430.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$283.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$774.94
|
| Rate for Payer: Priority Health Medicare |
$430.90
|
| Rate for Payer: Priority Health Narrow Network |
$774.94
|
| Rate for Payer: UHC Medicare Advantage |
$443.83
|
|
|
PR I&D INTRAMURAL IM/ABSC TRANSANAL ANES
|
Facility
|
OP
|
$722.00
|
|
|
Service Code
|
CPT 46045
|
| Hospital Charge Code |
46045
|
| Min. Negotiated Rate |
$505.40 |
| Max. Negotiated Rate |
$3,119.72 |
| Rate for Payer: Aetna Commercial |
$649.80
|
| Rate for Payer: Aetna Medicare |
$2,495.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,119.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,119.72
|
| Rate for Payer: ASR ASR |
$700.34
|
| Rate for Payer: BCBS Complete |
$1,433.58
|
| Rate for Payer: BCBS MAPPO |
$2,495.78
|
| Rate for Payer: BCBS Trust/PPO |
$559.77
|
| Rate for Payer: BCN Commercial |
$559.77
|
| Rate for Payer: BCN Medicare Advantage |
$2,495.78
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Cash Price |
$577.60
|
| Rate for Payer: Cofinity Commercial |
$678.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$577.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,495.78
|
| Rate for Payer: Healthscope Commercial |
$722.00
|
| Rate for Payer: Healthscope Whirlpool |
$700.34
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,495.78
|
| Rate for Payer: Mclaren Commercial |
$649.80
|
| Rate for Payer: Mclaren Medicaid |
$1,365.19
|
| Rate for Payer: Mclaren Medicare |
$2,495.78
|
| Rate for Payer: Meridian Medicaid |
$1,433.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,620.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,870.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$613.70
|
| Rate for Payer: PACE Medicare |
$2,370.99
|
| Rate for Payer: PACE SWMI |
$2,495.78
|
| Rate for Payer: PHP Commercial |
$2,745.36
|
| Rate for Payer: PHP Medicaid |
$1,365.19
|
| Rate for Payer: PHP Medicare Advantage |
$2,495.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,365.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$657.02
|
| Rate for Payer: Priority Health Medicare |
$2,495.78
|
| Rate for Payer: Priority Health Narrow Network |
$512.62
|
| Rate for Payer: Railroad Medicare Medicare |
$2,495.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$635.36
|
| Rate for Payer: UHC Medicare Advantage |
$2,570.65
|
| Rate for Payer: VA VA |
$2,495.78
|
|
|
PR I&D ISCHIORCT/INTRAMURAL ABSC W/WO SETON
|
Professional
|
Both
|
$2,085.00
|
|
|
Service Code
|
HCPCS 46060
|
| Min. Negotiated Rate |
$313.54 |
| Max. Negotiated Rate |
$1,459.50 |
| Rate for Payer: Aetna Commercial |
$640.13
|
| Rate for Payer: Aetna Medicare |
$477.71
|
| Rate for Payer: BCBS Complete |
$329.22
|
| Rate for Payer: BCBS MAPPO |
$477.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,438.03
|
| Rate for Payer: BCN Commercial |
$715.42
|
| Rate for Payer: BCN Medicare Advantage |
$477.71
|
| Rate for Payer: Cash Price |
$1,668.00
|
| Rate for Payer: Cash Price |
$1,668.00
|
| Rate for Payer: Cofinity Commercial |
$687.90
|
| Rate for Payer: Cofinity Commercial |
$640.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$477.71
|
| Rate for Payer: Healthscope Commercial |
$573.25
|
| Rate for Payer: Healthscope Whirlpool |
$573.25
|
| Rate for Payer: Meridian Medicaid |
$329.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$501.60
|
| Rate for Payer: PACE SWMI |
$477.71
|
| Rate for Payer: PHP Medicare Advantage |
$477.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$313.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,459.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$860.79
|
| Rate for Payer: Priority Health Medicare |
$477.71
|
| Rate for Payer: Priority Health Narrow Network |
$860.79
|
| Rate for Payer: UHC Medicare Advantage |
$492.04
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Professional
|
Both
|
$906.00
|
|
|
Service Code
|
HCPCS 46040
|
| Hospital Charge Code |
46040
|
| Min. Negotiated Rate |
$274.77 |
| Max. Negotiated Rate |
$1,260.52 |
| Rate for Payer: Aetna Commercial |
$558.85
|
| Rate for Payer: Aetna Medicare |
$417.05
|
| Rate for Payer: BCBS Complete |
$288.51
|
| Rate for Payer: BCBS MAPPO |
$417.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,260.52
|
| Rate for Payer: BCN Commercial |
$816.58
|
| Rate for Payer: BCN Medicare Advantage |
$417.05
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cofinity Commercial |
$558.85
|
| Rate for Payer: Cofinity Commercial |
$600.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$417.05
|
| Rate for Payer: Healthscope Commercial |
$500.46
|
| Rate for Payer: Healthscope Whirlpool |
$500.46
|
| Rate for Payer: Meridian Medicaid |
$288.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$437.90
|
| Rate for Payer: PACE SWMI |
$417.05
|
| Rate for Payer: PHP Medicare Advantage |
$417.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$751.43
|
| Rate for Payer: Priority Health Medicare |
$417.05
|
| Rate for Payer: Priority Health Narrow Network |
$751.43
|
| Rate for Payer: UHC Medicare Advantage |
$429.56
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Facility
|
OP
|
$906.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
46040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$573.77 |
| Max. Negotiated Rate |
$3,441.80 |
| Rate for Payer: Aetna Commercial |
$815.40
|
| Rate for Payer: Aetna Medicare |
$1,048.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,311.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,311.18
|
| Rate for Payer: ASR ASR |
$878.82
|
| Rate for Payer: BCBS Complete |
$602.51
|
| Rate for Payer: BCBS MAPPO |
$1,048.94
|
| Rate for Payer: BCBS Trust/PPO |
$702.42
|
| Rate for Payer: BCN Commercial |
$702.42
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.94
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cofinity Commercial |
$851.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$724.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.94
|
| Rate for Payer: Healthscope Commercial |
$906.00
|
| Rate for Payer: Healthscope Whirlpool |
$878.82
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,048.94
|
| Rate for Payer: Mclaren Commercial |
$815.40
|
| Rate for Payer: Mclaren Medicaid |
$573.77
|
| Rate for Payer: Mclaren Medicare |
$1,048.94
|
| Rate for Payer: Meridian Medicaid |
$602.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,101.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,206.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$770.10
|
| Rate for Payer: PACE Medicare |
$996.49
|
| Rate for Payer: PACE SWMI |
$1,048.94
|
| Rate for Payer: PHP Commercial |
$1,153.83
|
| Rate for Payer: PHP Medicaid |
$573.77
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,441.80
|
| Rate for Payer: Priority Health Medicare |
$1,048.94
|
| Rate for Payer: Priority Health Narrow Network |
$2,753.44
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$797.28
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
| Rate for Payer: VA VA |
$1,048.94
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Professional
|
Both
|
$906.00
|
|
|
Service Code
|
HCPCS 46040
|
| Min. Negotiated Rate |
$274.77 |
| Max. Negotiated Rate |
$1,260.52 |
| Rate for Payer: Aetna Commercial |
$558.85
|
| Rate for Payer: Aetna Medicare |
$417.05
|
| Rate for Payer: BCBS Complete |
$288.51
|
| Rate for Payer: BCBS MAPPO |
$417.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,260.52
|
| Rate for Payer: BCN Commercial |
$816.58
|
| Rate for Payer: BCN Medicare Advantage |
$417.05
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cofinity Commercial |
$600.55
|
| Rate for Payer: Cofinity Commercial |
$558.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$417.05
|
| Rate for Payer: Healthscope Commercial |
$500.46
|
| Rate for Payer: Healthscope Whirlpool |
$500.46
|
| Rate for Payer: Meridian Medicaid |
$288.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$437.90
|
| Rate for Payer: PACE SWMI |
$417.05
|
| Rate for Payer: PHP Medicare Advantage |
$417.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$751.43
|
| Rate for Payer: Priority Health Medicare |
$417.05
|
| Rate for Payer: Priority Health Narrow Network |
$751.43
|
| Rate for Payer: UHC Medicare Advantage |
$429.56
|
|
|
PR I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX
|
Facility
|
IP
|
$906.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
46040
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$634.20 |
| Max. Negotiated Rate |
$906.00 |
| Rate for Payer: Aetna Commercial |
$815.40
|
| Rate for Payer: ASR ASR |
$878.82
|
| Rate for Payer: BCBS Trust/PPO |
$702.42
|
| Rate for Payer: BCN Commercial |
$702.42
|
| Rate for Payer: Cash Price |
$724.80
|
| Rate for Payer: Cofinity Commercial |
$851.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$724.80
|
| Rate for Payer: Healthscope Commercial |
$906.00
|
| Rate for Payer: Healthscope Whirlpool |
$878.82
|
| Rate for Payer: Mclaren Commercial |
$815.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$770.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$797.28
|
|
|
PR I&D OF BARTHOLINS GLAND ABSCESS
|
Professional
|
Both
|
$378.00
|
|
|
Service Code
|
HCPCS 56420
|
| Min. Negotiated Rate |
$71.36 |
| Max. Negotiated Rate |
$275.12 |
| Rate for Payer: Aetna Commercial |
$146.27
|
| Rate for Payer: Aetna Medicare |
$109.16
|
| Rate for Payer: BCBS Complete |
$74.93
|
| Rate for Payer: BCBS MAPPO |
$109.16
|
| Rate for Payer: BCBS Trust/PPO |
$244.07
|
| Rate for Payer: BCN Commercial |
$275.12
|
| Rate for Payer: BCN Medicare Advantage |
$109.16
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cofinity Commercial |
$157.19
|
| Rate for Payer: Cofinity Commercial |
$146.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.16
|
| Rate for Payer: Healthscope Commercial |
$130.99
|
| Rate for Payer: Healthscope Whirlpool |
$130.99
|
| Rate for Payer: Meridian Medicaid |
$74.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$114.62
|
| Rate for Payer: PACE SWMI |
$109.16
|
| Rate for Payer: PHP Medicare Advantage |
$109.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$264.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$158.59
|
| Rate for Payer: Priority Health Medicare |
$109.16
|
| Rate for Payer: Priority Health Narrow Network |
$158.59
|
| Rate for Payer: UHC Medicare Advantage |
$112.43
|
|
|
PR I&D PELVIS/HIP JOINT AREA INFECTED BURSA
|
Professional
|
Both
|
$1,220.00
|
|
|
Service Code
|
HCPCS 26991
|
| Min. Negotiated Rate |
$342.08 |
| Max. Negotiated Rate |
$1,049.19 |
| Rate for Payer: Aetna Commercial |
$698.38
|
| Rate for Payer: Aetna Medicare |
$521.18
|
| Rate for Payer: BCBS Complete |
$359.18
|
| Rate for Payer: BCBS MAPPO |
$521.18
|
| Rate for Payer: BCBS Trust/PPO |
$758.11
|
| Rate for Payer: BCN Commercial |
$1,049.19
|
| Rate for Payer: BCN Medicare Advantage |
$521.18
|
| Rate for Payer: Cash Price |
$976.00
|
| Rate for Payer: Cash Price |
$976.00
|
| Rate for Payer: Cofinity Commercial |
$750.50
|
| Rate for Payer: Cofinity Commercial |
$698.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$521.18
|
| Rate for Payer: Healthscope Commercial |
$625.42
|
| Rate for Payer: Healthscope Whirlpool |
$625.42
|
| Rate for Payer: Meridian Medicaid |
$359.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$547.24
|
| Rate for Payer: PACE SWMI |
$521.18
|
| Rate for Payer: PHP Medicare Advantage |
$521.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$854.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$813.46
|
| Rate for Payer: Priority Health Medicare |
$521.18
|
| Rate for Payer: Priority Health Narrow Network |
$813.46
|
| Rate for Payer: UHC Medicare Advantage |
$536.82
|
|
|
PR I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA
|
Facility
|
IP
|
$1,483.00
|
|
|
Service Code
|
CPT 26990
|
| Hospital Charge Code |
26990
|
| Min. Negotiated Rate |
$1,038.10 |
| Max. Negotiated Rate |
$1,483.00 |
| Rate for Payer: Aetna Commercial |
$1,334.70
|
| Rate for Payer: ASR ASR |
$1,438.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,149.77
|
| Rate for Payer: BCN Commercial |
$1,149.77
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cofinity Commercial |
$1,394.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,186.40
|
| Rate for Payer: Healthscope Commercial |
$1,483.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,438.51
|
| Rate for Payer: Mclaren Commercial |
$1,334.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,260.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,305.04
|
|
|
PR I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$1,483.00
|
|
|
Service Code
|
HCPCS 26990
|
| Min. Negotiated Rate |
$433.21 |
| Max. Negotiated Rate |
$1,049.90 |
| Rate for Payer: Aetna Commercial |
$895.01
|
| Rate for Payer: Aetna Medicare |
$667.92
|
| Rate for Payer: BCBS Complete |
$462.50
|
| Rate for Payer: BCBS MAPPO |
$667.92
|
| Rate for Payer: BCBS Trust/PPO |
$433.21
|
| Rate for Payer: BCN Commercial |
$1,004.72
|
| Rate for Payer: BCN Medicare Advantage |
$667.92
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cofinity Commercial |
$895.01
|
| Rate for Payer: Cofinity Commercial |
$961.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$667.92
|
| Rate for Payer: Healthscope Commercial |
$801.50
|
| Rate for Payer: Healthscope Whirlpool |
$801.50
|
| Rate for Payer: Meridian Medicaid |
$462.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$701.32
|
| Rate for Payer: PACE SWMI |
$667.92
|
| Rate for Payer: PHP Medicare Advantage |
$667.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,049.90
|
| Rate for Payer: Priority Health Medicare |
$667.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,049.90
|
| Rate for Payer: UHC Medicare Advantage |
$687.96
|
|
|
PR I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$1,483.00
|
|
|
Service Code
|
HCPCS 26990
|
| Hospital Charge Code |
26990
|
| Min. Negotiated Rate |
$433.21 |
| Max. Negotiated Rate |
$1,049.90 |
| Rate for Payer: Aetna Commercial |
$895.01
|
| Rate for Payer: Aetna Medicare |
$667.92
|
| Rate for Payer: BCBS Complete |
$462.50
|
| Rate for Payer: BCBS MAPPO |
$667.92
|
| Rate for Payer: BCBS Trust/PPO |
$433.21
|
| Rate for Payer: BCN Commercial |
$1,004.72
|
| Rate for Payer: BCN Medicare Advantage |
$667.92
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cofinity Commercial |
$961.80
|
| Rate for Payer: Cofinity Commercial |
$895.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$667.92
|
| Rate for Payer: Healthscope Commercial |
$801.50
|
| Rate for Payer: Healthscope Whirlpool |
$801.50
|
| Rate for Payer: Meridian Medicaid |
$462.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$701.32
|
| Rate for Payer: PACE SWMI |
$667.92
|
| Rate for Payer: PHP Medicare Advantage |
$667.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$440.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,049.90
|
| Rate for Payer: Priority Health Medicare |
$667.92
|
| Rate for Payer: Priority Health Narrow Network |
$1,049.90
|
| Rate for Payer: UHC Medicare Advantage |
$687.96
|
|
|
PR I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA
|
Facility
|
OP
|
$1,483.00
|
|
|
Service Code
|
CPT 26990
|
| Hospital Charge Code |
26990
|
| Min. Negotiated Rate |
$1,038.10 |
| Max. Negotiated Rate |
$3,596.44 |
| Rate for Payer: Aetna Commercial |
$1,334.70
|
| Rate for Payer: Aetna Medicare |
$2,877.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: ASR ASR |
$1,438.51
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,149.77
|
| Rate for Payer: BCN Commercial |
$1,149.77
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cash Price |
$1,186.40
|
| Rate for Payer: Cofinity Commercial |
$1,394.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,186.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$1,483.00
|
| Rate for Payer: Healthscope Whirlpool |
$1,438.51
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,877.15
|
| Rate for Payer: Mclaren Commercial |
$1,334.70
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,260.55
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$3,164.86
|
| Rate for Payer: PHP Medicaid |
$1,573.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,038.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,349.53
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,052.93
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,305.04
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: VA VA |
$2,877.15
|
|
|
PR I&D PENIS DEEP
|
Professional
|
Both
|
$751.00
|
|
|
Service Code
|
HCPCS 54015
|
| Min. Negotiated Rate |
$194.26 |
| Max. Negotiated Rate |
$2,212.52 |
| Rate for Payer: Aetna Commercial |
$398.84
|
| Rate for Payer: Aetna Medicare |
$297.64
|
| Rate for Payer: BCBS Complete |
$203.97
|
| Rate for Payer: BCBS MAPPO |
$297.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,212.52
|
| Rate for Payer: BCN Commercial |
$439.81
|
| Rate for Payer: BCN Medicare Advantage |
$297.64
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cash Price |
$600.80
|
| Rate for Payer: Cofinity Commercial |
$428.60
|
| Rate for Payer: Cofinity Commercial |
$398.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$297.64
|
| Rate for Payer: Healthscope Commercial |
$357.17
|
| Rate for Payer: Healthscope Whirlpool |
$357.17
|
| Rate for Payer: Meridian Medicaid |
$203.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$312.52
|
| Rate for Payer: PACE SWMI |
$297.64
|
| Rate for Payer: PHP Medicare Advantage |
$297.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$525.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$486.31
|
| Rate for Payer: Priority Health Medicare |
$297.64
|
| Rate for Payer: Priority Health Narrow Network |
$486.31
|
| Rate for Payer: UHC Medicare Advantage |
$306.57
|
|
|
PR I&D PERIANAL ABSCESS SUPERFICIAL
|
Professional
|
Both
|
$441.00
|
|
|
Service Code
|
HCPCS 46050
|
| Min. Negotiated Rate |
$65.39 |
| Max. Negotiated Rate |
$1,360.90 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: Aetna Medicare |
$98.99
|
| Rate for Payer: BCBS Complete |
$68.66
|
| Rate for Payer: BCBS MAPPO |
$98.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,360.90
|
| Rate for Payer: BCN Commercial |
$349.40
|
| Rate for Payer: BCN Medicare Advantage |
$98.99
|
| Rate for Payer: Cash Price |
$352.80
|
| Rate for Payer: Cash Price |
$352.80
|
| Rate for Payer: Cofinity Commercial |
$142.55
|
| Rate for Payer: Cofinity Commercial |
$132.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.99
|
| Rate for Payer: Healthscope Commercial |
$118.79
|
| Rate for Payer: Healthscope Whirlpool |
$118.79
|
| Rate for Payer: Meridian Medicaid |
$68.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$103.94
|
| Rate for Payer: PACE SWMI |
$98.99
|
| Rate for Payer: PHP Medicare Advantage |
$98.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$178.75
|
| Rate for Payer: Priority Health Medicare |
$98.99
|
| Rate for Payer: Priority Health Narrow Network |
$178.75
|
| Rate for Payer: UHC Medicare Advantage |
$101.96
|
|
|
PR I&D SHOULDER DEEP ABSCESS/HEMATOMA
|
Professional
|
Both
|
$702.00
|
|
|
Service Code
|
HCPCS 23030
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$648.96 |
| Rate for Payer: Aetna Commercial |
$335.66
|
| Rate for Payer: Aetna Medicare |
$250.49
|
| Rate for Payer: BCBS Complete |
$172.88
|
| Rate for Payer: BCBS MAPPO |
$250.49
|
| Rate for Payer: BCBS Trust/PPO |
$33.96
|
| Rate for Payer: BCN Commercial |
$648.96
|
| Rate for Payer: BCN Medicare Advantage |
$250.49
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cofinity Commercial |
$335.66
|
| Rate for Payer: Cofinity Commercial |
$360.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$250.49
|
| Rate for Payer: Healthscope Commercial |
$300.59
|
| Rate for Payer: Healthscope Whirlpool |
$300.59
|
| Rate for Payer: Meridian Medicaid |
$172.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$263.01
|
| Rate for Payer: PACE SWMI |
$250.49
|
| Rate for Payer: PHP Medicare Advantage |
$250.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$390.65
|
| Rate for Payer: Priority Health Medicare |
$250.49
|
| Rate for Payer: Priority Health Narrow Network |
$390.65
|
| Rate for Payer: UHC Medicare Advantage |
$258.00
|
|
|
PR I&D SHOULDER INFECTED BURSA
|
Professional
|
Both
|
$706.00
|
|
|
Service Code
|
HCPCS 23031
|
| Min. Negotiated Rate |
$18.68 |
| Max. Negotiated Rate |
$639.67 |
| Rate for Payer: Aetna Commercial |
$292.21
|
| Rate for Payer: Aetna Medicare |
$218.07
|
| Rate for Payer: BCBS Complete |
$151.41
|
| Rate for Payer: BCBS MAPPO |
$218.07
|
| Rate for Payer: BCBS Trust/PPO |
$18.68
|
| Rate for Payer: BCN Commercial |
$639.67
|
| Rate for Payer: BCN Medicare Advantage |
$218.07
|
| Rate for Payer: Cash Price |
$564.80
|
| Rate for Payer: Cash Price |
$564.80
|
| Rate for Payer: Cofinity Commercial |
$314.02
|
| Rate for Payer: Cofinity Commercial |
$292.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.07
|
| Rate for Payer: Healthscope Commercial |
$261.68
|
| Rate for Payer: Healthscope Whirlpool |
$261.68
|
| Rate for Payer: Meridian Medicaid |
$151.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.97
|
| Rate for Payer: PACE SWMI |
$218.07
|
| Rate for Payer: PHP Medicare Advantage |
$218.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$494.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$341.63
|
| Rate for Payer: Priority Health Medicare |
$218.07
|
| Rate for Payer: Priority Health Narrow Network |
$341.63
|
| Rate for Payer: UHC Medicare Advantage |
$224.61
|
|
